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妊娠期糖尿病风险增加的不同种族女性的健康行为:影响母婴健康的行为(B.A.B.Y.)研究

The Health Behaviors of Ethnically Diverse Women at Increased Risk of Gestational Diabetes: The Behaviors Affecting Baby and You (B.A.B.Y.) Study.

作者信息

Nobles Carrie J, Marcus Bess H, Stanek Edward J, Braun Barry, Whitcomb Brian W, Manson JoAnn E, Markenson Glenn, Chasan-Taber Lisa

机构信息

Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.

Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, CA, USA.

出版信息

Matern Child Health J. 2018 May;22(5):735-744. doi: 10.1007/s10995-018-2442-0.

Abstract

Objectives Cigarette smoking, low physical activity, and sedentary behavior are modifiable risk factors for adverse pregnancy outcomes. However, only one study has evaluated predictors of these health risk behaviors among women at high risk for gestational diabetes mellitus (GDM). Therefore, our goal was to examine predictors of smoking, low physical activity, and sedentary behavior during pregnancy in an ethnically diverse high risk cohort. Methods This cross-sectional analysis utilized baseline data from the Behaviors Affecting Baby and You (B.A.B.Y.) study conducted among prenatal care patients at high risk for GDM (personal history of GDM or family history of diabetes and body mass index [BMI] ≥ 25 kg/m). Smoking was assessed using questions from the Pregnancy Risk Assessment Monitoring System questionnaire and sedentary behavior (top vs. lower quartiles) and moderate/vigorous physical activity (bottom vs. upper quartile) via the Pregnancy Physical Activity Questionnaire. Results Participants (n = 400) enrolled at a mean of 12.4 (SD 3.6) weeks gestation. A total of 150 (44.1%) engaged in one, 37 (10.9%) in two, and 4 (1.2%) in three risk behaviors. Lower household income and not having children at home were each associated with a 2-6 fold increased odds of smoking, high sedentary behavior, and engaging in at least one risk behavior. Being married, Hispanic or of younger age was associated with a 2-6 fold reduced odds of smoking. BMI and personal history of GDM were not associated with risk behaviors. Conclusions for Practice Findings help characterize high risk groups and inform prenatal interventions targeting these health risk behaviors.

摘要

目的 吸烟、缺乏体育锻炼和久坐行为是可改变的不良妊娠结局风险因素。然而,仅有一项研究评估了妊娠糖尿病(GDM)高危女性中这些健康风险行为的预测因素。因此,我们的目标是在一个种族多样的高危队列中研究孕期吸烟、缺乏体育锻炼和久坐行为的预测因素。方法 这项横断面分析利用了“影响宝宝和你(B.A.B.Y.)”研究的基线数据,该研究在GDM高危的产前护理患者(有GDM个人史或糖尿病家族史且体重指数[BMI]≥25 kg/m²)中开展。吸烟情况通过妊娠风险评估监测系统问卷中的问题进行评估,久坐行为(上四分位数与下四分位数)和中度/剧烈体育活动(下四分位数与上四分位数)通过妊娠身体活动问卷进行评估。结果 参与者(n = 400)平均在妊娠12.4(标准差3.6)周时入组。共有150人(44.1%)存在一种、37人(10.9%)存在两种、4人(1.2%)存在三种风险行为。家庭收入较低和家中没有孩子与吸烟、久坐行为及至少存在一种风险行为的几率增加2至6倍相关。已婚、西班牙裔或年龄较小与吸烟几率降低2至6倍相关。BMI和GDM个人史与风险行为无关。实践结论 研究结果有助于明确高危群体,并为针对这些健康风险行为的产前干预提供信息。

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